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Home My WebLink AboutBLD2024-00918 - BLD CD Environmental Health Review - 7/31/2024 Permit No: 'V� MASON COUNTY COMMUNITY DEVELOPMENT Permit Assistance Center,Building,Planning BUILDING PERMIT APPLICATION p ✓l, PROPERTY OWNF.RINFORMATION: CONTRACTOR INFORMATIO ,�1 IG NAY sF NAME: F7ICRLSsI•/ � .c MAILING ADDRES ETS: t7..0 h.LAI C MAILING ADDRESS: toi 17., CITY: S c flw-x t STATE:uyg ZIP: gagw. CITY: ,gbtecrnLL STATE- ja ZIP: PHONE#1:,3A- !LM- it¢2 PHONE:31e0-van-4gdt CELL: R PHONE#2: EMAIL lk .i nu Q.NSSa) Cab EMAIL: gvi_ M g,asd erxM L&I REG# grx iKRqkQ_lO—E%P.2/.W-/may PRIMARY CONTACT: OWNER❑ CONTRACTOR B OTHER❑ NAME EMAIL p�_6a;lL Arnsa✓. `'r►sa MAILINGADDRESS (O( . F ZC99CLFrr£ Cr CITY dtFe-mT )— STATE LOA ZIP-51MV2f PHONE 340- V34 3/9r? CELL sLrs-�r>-0efh/ PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) 1,01 ZONING LEGAL DESCRIPTION(Abbreviated)AN) FIRE DISTRIC— SITEADDRESS 5,5A E. Pannx ed it-A. CITY -ZM- mcJ utA- DIli W��-yI7ONS11T��STT DD��ttEESS TI(L16, OIYL1�.Pi IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NOW SNOW LOADi IS PROPERTY WITffiN 200 FT OF THE FOLLOWING: (Checkau rhm opply): SALTWATER❑ LAKE❑ RWER/CREEK❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW N ADDITION ❑ ALTERATION❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(.;d.m C' 'Commemia7Bldg.Ere.) ZF�L IS USE: PRIMARY 51 SEASONAL❑ NUMBER OF BEDROOMS NUMBER OF BATHROOMS HEATBD STRUCTURE? YES(Wlw/a BkW❑ YES(F4HA]ofBWg1 ❑ NO❑ DESCRIBE WORK .1/BJ e, // SOU ARE 1 l0 1ST FLOOR sq-1 2ND FLOOR sq.tL 3RD FLOOR sq.ft BASEMENT sq.ft. DECK-jk�sq.ft. COVERED DEC j�0 0 eq.rc STORAGE sq.ft. OTHER sq.ft GARAGE sq.ft. Attached 0 Detached❑ CARPORT_ sq.R Attached❑ Detached- MANUFA ORMATION: *4 COPIES OF THE FLOORPLAN REQUIRED* a MA MODEL YEAR LENGTH TH BEDROOMS BATHS R) ENVIRONMENTAL HEALTH: SEWAGE/SEWER.SOURCE: SEPTIC❑ SEWER / NEW EXISTINGgf PLUMBING IN STRUCTURE? YES j? T O❑ If yes,attach completed Water Adequacy Form PERIMETER(FOUNDATION DRAINS PROPOSED? YES❑ NO❑ EXISTING SQ.Fr. EXISTING BEDROOMS PROPOSED BEDROOMS TOTAL BEDROOMS-!3o-- OWNER ackrlowtedges that submission of inacglrete Information may result In a stop work order or permit revocation.AdmWedgemem of such is by signature below.I declare that I am the owner and I further declare that I am entitled to recel"this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal rnnm tmlw rw„osmle mw me imm�nalen nrm,Nen is aminaln ann nram<mm�mvnx nr nAacnn Iry inw nrmcs In mn nnnw msrnro,+mm�ndv - �e a i- 3 �3Nil g p Q , a W i o � ° =' x 0 oaroo - y {YYaxl,�I` a R S 6 x m Psk a C Qm pS aN EC „Er � �s aS8 > " m O < ^ y a � 9e c k g w i 6 F w 9 S s� •�� I � z a J oil all